Lichtenstein technique for inguinal hernia repair: ten recommendations to optimize surgical outcomes.

Purpose: Approximately 20 million individuals worldwide undergo inguinal hernia surgery annually. The Lichtenstein technique is the most commonly used surgical procedure in this setting. The objective of this study was to revisit this technique and present ten recommendations based on the best practices.

The Lichtenstein technique is being used adequately in inguinal hernia repair: national analysis and review of the surgical technique.

Introduction: it is estimated that approximately 20 million people undergo inguinal hernia surgery annually in the world, with the Lichtenstein technique being the most performed surgical procedure. The objective of this study is to analyze the knowledge of the technical principles used in the Lichtenstein technique.

Method: Survey-type intersectional study approved by the research ethics committee of São Camilo University Center (CAAE: 70036523.

Endoscopic Mini-or Less-Open Sublay Operation (E/MILOS) in ventral hernia repair: a minimally invasive alternative technique.

The ideal ventral hernia surgical repair is still in discussion1. The defect closure with a mesh-based repair is the base of surgical repair, in open or minimally invasive techniques2. The open methods lead to a higher surgical site infections incidence, meanwhile, the laparoscopic IPOM (intraperitoneal onlay mesh) increases the risk of intestinal lesions, adhesions, and bowel obstruction, in addition to requiring double mesh and fixation products which increase its costs and could worsen the post-operative pain3-5.

ARE THERE DIFFERENCES IN CHRONIC PAIN AFTER LAPAROSCOPIC INGUINAL HERNIA REPAIR USING THE TRANSABDOMINAL TECHNIQUE COMPARING WITH FIXATION OF THE MESH WITH STAPLES, WITH GLUE OR WITHOUT FIXATION? A CLINICAL RANDOMIZED, DOUBLE-BLIND TRIAL.

Background: Regarding postoperative pain, it remains unclear whether non-fixation of the polypropylene prosthesis in transabdominal preperitoneal inguinal hernia repair produces the same outcomes as mesh fixation with glue or tackers. In addition, hernia recurrence is another aspect to be assessed in the comparison between non-fixation and mesh-fixation techniques (tackers and glue).

Aims: This study aimed to evaluate the incidence, quality of pain, and recurrence in patients undergoing laparoscopic inguinal hernioplasty (transabdominal preperitoneal) technique, comparing the fixation of the mesh with tackers versus with glue versus without fixation.

Prospective study of the Iliac Bicrest Pubic Angle through the 3D reconstruction of the bone pelvis and the correlation with giant incisional hernia.

Objective: to describe and measure the Bicrista Iliaca Pubo Angle (APBCI) as a new anthropometric parameter. Correlate the measurement with patients with giant incisional hernia (HIG), in the midline of the anterior abdominal wall (AAW).

Methods: measurement of APBCI, through 3D reconstruction from computed tomography (CT).

Robotic re-TAPP: a minimally invasive alternative for the failed posterior repair.

Objective: to describe the use of the robotic platform in inguinal hernia recurrence after a previous laparoscopic repair.

Methods: patients with recurrent inguinal hernias following a laparoscopic repair who have undergone robotic transabdominal preperitoneal between December 2015 through September 2020 were identified in a prospectively maintained database. Outcomes of interest included demographics, hernia characteristics, operative details and rates of 30-day surgical site occurrence, surgical site occurrences requiring procedural interventions, surgical site infection and hernia recurrence were abstracted.

Reversal of unstable atrial fibrillation after surgical correction of hiatus hernia: A case report.

Introduction: The presence of Atrial Fibrillation (AF) with herniation of abdominal content through the esophageal hiatus can be explained by the compression of the cardiac tissue by the viscera and, consequently, of its electrical transmission network, compromising the correct propagation of stimuli. Due to the causal relationship, hernia correction is almost always able to reverse the arrhythmic picture.

Presentation Of The Case: A 75-year-old male with atrial fibrillation with a large hiatal hernia causing clinical decompensation was successfully treated after a laparocopic correction- primary closure of the defect was made with barbed surgical thread plus and placing a biological mesh (porcine small intestine submucosa, non-cross-linked), fixed with cyanoacrylate; after the procedure, he was discharged asymptomatic and with sinus heart rhythm.

Autoimmune [auto-inflammatory] syndrome induced by adjuvants (ASIA): Case report after inguinal hernia repair with mesh.

Introduction: There has been a great advance in the treatment of inguinal hernias with a significant reduction in recurrences with the use of polypropylene mesh. Local complications such as infections, rejection, and chronic pain are widely studied and reported in the literature. The Autoimmune [Auto-inflammatory] Syndrome Induced by Adjuvants (ASIA) is little known and can be triggered by using polypropylene mesh.

Pancreatoduodenal Artery Aneurism rupture post colonoscopy - Case report.

Introduction: Complications related to colonoscopy is considered low and in most cases involves intestinal perforation. Vascular complications involving aneurysm rupture are rare in the literature and may occur after colonoscopy.

Presentation Of The Case: We report a case of a 58-year-old male patient that ruptured pancreatoduodenal artery aneurysm after colonoscopy, successfully submitted to endovascular treatment.

Biomechanical and adhesion comparison of linea alba prophylactic reinforcement with coated and uncoated three-dimensional T-shaped mesh in rabbits.

Purpose: Incisional hernia (IH) is a frequent complication of median laparotomy. The use of prophylactic mesh to reduce IH incidence has gained increasing attention. We hypothesized that in an animal model, linea alba prophylactic reinforcement with a three-dimensional T-shaped polypropylene mesh results in greater abdominal wall resistance.

COVID-19 and Cytomegalovirus Co-infection: A Challenging Case of a Critically Ill Patient with Gastrointestinal Symptoms.

Unlabelled: COVID-19 is a severe disease that has reached pandemic status. To the best of our knowledge, we describe the first case of COVID-19 and cytomegalovirus (CMV) co-infection in a critically ill patient. We discuss the challenge of establishing the diagnosis as well as the management of tissue-invasive gastrointestinal CMV infection (TI-GI CMV) simulating vascular involvement and intestinal obstruction in a critically ill patient.

Guidelines of the Brazilian Hernia Society (BHS) for the management of inguinocrural hernias in adults.

Inguinal hernias are a frequent problem and their repair is the most commonly performed procedure by general surgeons. In the last years, new principles, products and techniques have changed the routine of surgeons, who need to recycle knowledge and perfect new skills. In addition, old concepts regarding surgical indication and risk of complications have been reevaluated.

Robotic Transversus Abdominis Release (TAR): is it possible to offer minimally invasive surgery for abdominal wall complex defects?

We describe the preliminary national experience and the early results of the use of robotic surgery to perform the posterior separation of abdominal wall components by the Transversus Abdominis Release (TAR) technique for the correction of complex defects of the abdominal wall. We performed the procedures between 04/2/2015 and 06/15/2015 and the follow-up time was up to six months, with a minimum of two months. The mean surgical time was five hours and 40 minutes.

Centralized, capacity-building training of Lichtenstein hernioplasty in Brazil.

Background: In Brazil, access to healthcare varies widely by community. Options for repair of surgically correctable conditions, such as inguinal hernias, are limited. A training program was instituted to expand access to Lichtenstein hernioplasty.

Prospective study of the neurotopographic adequacy of transverse incision in Lichtenstein inguinal hernioplasty.

Lichtenstein technique requires identification of the iliohypogastric, ilioinguinal, and genital branch of the genitofemoral nerves.The aim of the study was to verify if the transverse incision is suitable for identification of the iliohypogastric, ilioinguinal, and genital branch of the genitofemoral nerves.This study included 29 patients who underwent hernioplasty, and also 10 dissections of the inguinal regions from 5 cadavers.

Global Outreach Using a Systematic, Competency-Based Training Paradigm for Inguinal Hernioplasty.

Importance: Sustainable, capacity-building educational collaborations are essential to address the global burden of surgical disease.

Objective: To assess an international, competency-based training paradigm for hernia surgery in underserved countries.

Design, Setting, And Participants: In this prospective, observational study performed from November 1, 2013, through October 31, 2015, at 16 hospitals in Brazil, Ecuador, Haiti, Paraguay, and the Dominican Republic, surgeons completed initial training programs in hernia repair, underwent interval proficiency assessments, and were appointed regional trainers.

Effectiveness of the combined use of lactic acid film and polypropylene mesh in the formation of intraperitoneal adhesions--an experimental model in rats.

Objective: To evaluate the efficacy of a lactic acid biomaterial (SurgiWrap®) as a protector of the polypropylene mesh (Marlex®) regarding the formation of intraperitoneal adhesions in rats.

Methods: Forty Wistar rats formed the following groups: Group 0 (Sham)--only laparotomy; Group I--polypropylene mesh; Group II--polypropylene mesh protected by a film of lactic acid. These animals were submitted to laparotomy and placement (or not) of the meshes at closing.